Association Between Renal Function and Left Atrial Low-Voltage Area Burden in Paroxysmal Atrial Fibrillation

Circumferential pulmonary vein isolation (CPVI) plus left atrial low-voltage areas (LVA) modification is a useful method to treat paroxysmal atrial fibrillation (PAF); however, it is hard to predict LVA burden before the procedure. The existence of chronic kidney disease (CKD) increases the prevalence of left atrial LVA. In this study, we explored the relationship between renal function and the LVA burden in elderly patients with PAF.

We retrospectively analyzed the 435 elderly patients with PAF who underwent ablation. Based on the LVA burden measured during the procedure, the patients were divided into four groups: Group 1 (LVA burden ≤ 5%, n = 356), Group 2 (LVA burden 5%-10%, n = 39), Group 3 (LVA burden 10%-15%, n = 16), and Group 4 (LVA burden > 15%, n = 24).

Increasing LVA burden was associated with a progressive decline in eGFR. A significant difference was observed between Group 1 and Group 4 (86.6 ± 12.9 vs. 76.4 ± 17.7, p = 0.003). eGFR was identified to be a predictor for LVA burden > 10%, with the optimal cut-off value for GFR being 75.7 mL/min/1.73 m², having a sensitivity of 54.2% and specificity of 80.4%.

A lower eGFR is associated with higher LVA burden in elderly patients with PAF.